活动期溃疡性结肠炎患者体内血小板激活状态的评价

目的 探讨血小板激活和活动期溃疡性结肠炎的关系。方法 对32例活动期溃疡性结肠炎、11例缓解期溃疡性结肠炎、30例肠易激综合征（IBS）患者和正常对照组27例用SH－93智能血液凝聚仪检测血小板聚集率，用酶联免疫法检测P－选择素和血栓素B2（TXB2）。同时评价43例溃疡性结肠炎内镜下表现和结肠黏膜活检情况。结果 32例活动期溃疡性结肠炎患者平均1min血小板聚集率和最大血小板聚集率均明显高于IBS组和正常对照组（P＜0．01）；32例活动期溃疡性结肠炎P－选择素和TXB2明显高于IBS组和正常对照组，差异有显著性（P＜0．01或P＜0．05）。缓解期溃疡性结肠炎的P－选择素也高于正常对照组。结论 活动期溃疡性结肠炎患者体内存在血小板激活，血小板可能直接参与结肠黏膜的急性炎症反应。其中P－选择素是溃疡性结肠炎的特异性指标，而血小板聚集率和TXB2与疾病的活动度有关。抗血小板药物可能对溃疡性结肠炎有一定的治疗效果。     

狼疮肾炎患者血浆内皮素水平的变化及泼尼松与环磷酰胺冲击治疗对其影响

目的：探讨狼疮肾炎（LN）患者血浆内皮素（ET）的变化及泼尼松与环磷酰胺冲击治疗（IV－CTX）对其影响。方法；采用特异性的放射免疫法检测35名健康人（正常对照组）、30例稳定期LN患者和45例活动期LN患者IV－CTX治疗前后血浆ET水平。结果：稳定期LN患者血浆ET与政党对照组比较差别无显著性（P＞0．05），而活动期LN患者血浆ET水平显著高于稳定期组与正常对照组（P＜0．01），且血浆ET与抗双链DNA抗体、血沉、24h尿蛋白定量、尿素氮、血肌酐呈正相关（P＜0．01，P＜0．01，P＜0．05，P＜0．05，P＜0．01）。与补体C3、C4、内生肌酐清除率呈显著负相关（P＜0．01，P＜0．05，P＜0．01），轻度肾功能不全组LN患者血浆ET水平显著高于肾功能正常对照组（P＜0．01），泼尼松加IV－CTX能显著降低LN患者血浆ET水平（P＜0．01）。结论：ET参与了LN的发病过程，动态观测血浆ET水平有助于判断LN的活动性、肾脏损害程度和治疗效果。     

益生菌对溃疡性结肠炎患者肠黏膜屏障的修复作用

目的探讨益生菌对溃疡性结肠炎患者肠黏膜屏障的修复作用。方法将54例溃疡性结肠炎患者随机分为研究组和对照组。观察双歧杆菌、乳杆菌、嗜热链球菌治疗前1天、治疗后14天患者乳果糖、甘露醇尿液排泄率比值（LAC／MAN）以及血浆内毒素水平。结果益生菌治疗后患者肠黏膜通透性显著下降（P〈0．01），血浆内毒素水平也明显下降（P〈0．05）。结论益生菌可能对溃疡性结肠炎患者肠黏膜屏障有一定修复作用。     

检测C反应蛋白对冠心病诊断的临床意义

目的研究血浆C反应蛋白（CRP）水平与冠心病（CHD）严重程度之间的关系。方法冠心病组86例分成稳定型心绞痛组55例，急性心肌梗死组31例。正常对照组80例。用免疫散射光比浊法测定CRP含量。结果CRP浓度在正常对照组、稳定型心绞痛组、急性心肌梗死组依次增高，稳定型心绞痛组和急性心肌梗死组均明显高于对照组（P〈0．01），冠心病组间也有显著差异（P〈0．01）。结论血浆CRP浓度与冠心病病变程度有密切关系。     

脂泰胶囊对T2DM患者NO、ET及CRP的影响

将130例2型糖尿病患者分为高血脂脂泰组、非高血脂脂泰组和非高血脂常规治疗组。高血脂和非高血脂脂泰组在常规治疗的基础上加脂泰胶囊。分别测定治疗前及治疗6个月后血清一氧化氮（NO）、内皮素（ET）和C反应蛋白（CRP）,以50例健康人作为对照组。结果显示,血脂升高和不升高的2型糖尿病患者,血浆NO浓度都明显低于对照组（P〈0．01）,ET和CRP含量显著高于对照组（P〈0．01）;脂泰胶囊治疗后NO均显著升高（P〈0．01）,ET和CRP显著降低（P〈0．05）。2型糖尿病患者无论血脂水平高低都存在着动脉内皮功能损伤和动脉内膜的慢性炎症反应,脂泰胶囊治疗可减轻血脂不高的2型糖尿病患者的炎症反应。     

缺氧诱导因子-1α、环氧化酶-2和C反应蛋白联合检查用于溃疡性结肠炎诊断的研究

目的 探讨检测缺氧诱导因子-1α(HIF-1α)、环氧化酶-2(COX-2)和C反应蛋白(CRP)用于诊断溃疡性结肠炎的价值.方法 98例溃疡性结肠炎按照病情轻重分为A组(轻度)31例、B组(中度)34例和C组(重度)33例,25例未患溃疡性结肠炎志愿者作为对照组D.采用RT-PCR方法分析各组检查对象结肠组织处HIF-1α、COX-2和C反应蛋白mRNA转录水平.采用ELISA方法检测各组检查对象血清中HIF-1α、COX-2和C反应蛋白水平.结果 HIF-1α mRNA转录水平随着溃疡性结肠炎病情加重而逐渐增加;COX4 mRNA转录水平A组显著高于D组(P＜0.05),B组显著高于A组(P＜0.05),C组与B组差异无统计学意义(P＞0.05);CRP mRNA转录水平,B组显著高于A组(P＜0.05),C组显著高于B组(P＜0.05),A组与D组差异无统计学意义(P＞0.05).A组、B组和C组血清中HIF-1α、COX-2和C反应蛋白平均水平显著高于对照组D组(P均＜0.05),且随着溃疡性结肠炎病情加重水平逐渐升高.结论 病灶细胞中HIF-1α、COX-2和C反应蛋白mRNA转录水平和血清蛋白表达水平与溃疡性结肠炎病情进展呈正相关性,联合检测HIF-1α、COX-2和C反应蛋白有助于判断溃疡性结肠炎病情严重程度.     

辛伐他汀或阿托伐他汀对脑梗死患者血清CRP的影响

目的探讨血清C反应蛋白（CRP）与脑梗死病情严重性及预后的关系。方法将46例脑梗死患者分为对照组及辛伐他汀组（辛伐他汀40mg／d或阿托伐他汀20mg／d。连续用药7d）。治疗前后检测血清ClIP、血清谷草转氨酶（AST）及轿清肌酸激酶（CK）水平。结果治疗前CRP水平与当时及3个月时病情显著相关（P〈0．01，P/〈0．05）。治疗后他汀组CRP水平下降，治疗前后差值与对照组相比有显著差异（P〈0．01）。治疗后各组AST及CK水平无明显变化。结论脑梗死患者血清CRP水平与病情的严重性及预后相关。短期应用辛伐汀或阿托伐他汀可以降低脑梗死患者血清CRP水平，安全性好。     

D-二聚体、C反应蛋白、血沉与老年社区获得性肺炎严重程度的关系

目的探讨血浆D-二聚体、C反应蛋白（CRP）和血沉水平与老年社区获得性肺炎（CAP）严重程度的关系。方法收集130例老年CAP患者的临床资料,按不同的病情严重程度评分标准对患者进行分组,分别测定患者血浆D-二聚体、CRP、血沉水平,分析其在不同分组间的差异。结果不同肺炎严重度指数（PSI）分级间、不同CURB-65分组间D-二聚体、CRP水平比较差异均有统计学意义（P〈0．05）,重症肺炎组D-二聚体、CRP水平均显著高于非重症肺炎组（P〈0．01）。血沉水平在以上不同分组间比较差异均无统计学意义。血浆D-二聚体与CRP水平显著相关（r=0．368,P〈0．01）。结论血浆CRP、D-二聚体水平与CAP的严重程度有一定的相关性,可作为判断病情的指标。     

超敏C反应蛋白与冠心病的关系探讨

目的 探讨超敏C反应蛋白（hs—CRP）与冠心病的的关系。方法对51例急性心肌梗死患者、75例心绞痛患者、86例健康体检者测定hs—CRP水平，比较各组间hs-CRP水平差异。结果急性心肌梗死组、心绞痛组hs．CRP水平高于正常对照组（P〈0．05），急性心肌梗死组hs-CRP水平高于心绞痛组（P〈0．01）。结论动态监测hs—CRP水平，有助于冠心病病情监测。     

辛伐他汀并氯吡格雷对急性冠脉综合症患者高敏C反应蛋白及血脂的影响

目的：探讨辛伐他汀联用氢氯吡格雷对急性冠脉综合症患者高敏C反应蛋白（hs—CRP）及血脂的影响。方法：117例急性冠脉综合征患者被分成辛伐他汀常规治疗组（48例）和辛伐他汀联用氢氯吡格雷组（69例）。观察治疗后6周两组血浆hs—CRP和血脂含量的变化。结果：两组患者治疗后6周血浆hs—CRP、血脂水平均显著下降（P〈0．01）,但辛伐他汀联用氢氯吡格雷组的hs—CRP下降幅度较辛伐他汀组更大（P〈0．05）,两组血脂改善无显著差异（P〉0．05）。结论：辛伐他汀联用氢氯吡格雷应用于急性冠脉综合征患者,能更有效地降低血浆hs—CRP浓度。更有利于抑制炎症、稳定斑块。     

溃疡性结肠炎患者血C反应蛋白活性与尿白蛋白含量的变化及其临床意义

目的　探讨血C反应蛋白 (CRP)活性与尿白蛋白 (AU )含量在溃疡性结肠炎 (UC)患者病情活动性与严重性评价中的意义。方法　采用试剂盒与免疫散射比浊法检测 2 5例缓解期UC患者、3 2例活动期UC患者及 3 0例对照组的血浆CRP活性及AU含量 ,并对活动期患者行肠镜及病理组织学检查 ,评价病情轻重程度。结果　活动期患者组血CRP活性和AU含量显著高于缓解期组和对照组 (P <0 .0 1) ,且二者与UC病情活动性、病情分型均呈显著正相关 ,与内镜表现分级呈中度正相关 ,与病理组织学分级无相关性。结论　血CRP活性和AU含量可作为评价UC患者病情活动性及严重程度的良好指标     

Clinical value of fecal calprotectin in determining disease activity of ulcerative colitis

AIM： To investigate possibility and clinical application of fecal calprotectin in determining disease activity of ulcerative colitis （UC）. METHODS： The enzyme-linked immunosorbent assay （ELISA） was used to measure the concentrations of calprotectin in feces obtained from 66 patients with UC and 20 controls. C-reactive protein （CRP）, erythrocyte sedimentation rate （ESR）, acid glycoprotein （AGP） were also measured and were compared with calprotectin in determining disease activity of UC. The disease activity of UC was also determined by the Sutherland criteria. RESULTS： The fecal calprotectin concentration in the patients with active UC was significantly higher than that in the inactive UC and in the controls （402.16 ± 48.0 μg/g vs 35.93 ± 3.39 μg/g, 11.5 ± 3.42 μg/g, P 〈 0.01）. The fecal calprotectin concentration in the inactive UC group was significantly higher than that in the control group （P 〈 0.05）. A significant difference was also found in the patients with active UC of mild, moderate and severe degrees. The area under the curve of the receiver operating characteristics （AUCR~c） was 0.975, 0.740, 0.692 and 0.737 for fecal calprotectin, CRP, ESR and AGP, respectively. There was a strong correlation between the fecal calprotectin concentration and the endoscopic gradings for UC （r = 0.866, P 〈 0.001）. CONCLUSION： Calprotectin in the patient＇s feces can reflect the disease activity of UC and can be used as a rational fecal marker for intestinal inflammation in clinical practice. This kind of marker is relatively precise, simple and noninvasive when compared with other commonlyused markers such as CRP, ESR and AGP.     

活动期溃疡性结肠炎患者血清vaspin水平及其临床意义

脂肪细胞因子与机体内能量稳定相关,并介导多种免疫应答和炎症反应。内脏脂肪特异性丝氨酸蛋白酶抑制剂vaspin是近年发现的一种与炎症反应有关的脂肪细胞因子。目的:检测活动期溃疡性结肠炎(UC)患者的血清vaspin水平并探讨其临床意义。方法:选取2008年1月~2013年4月苏州市立医院收治的150例活动期UC患者,以150名健康体检者作为正常对照组。采用ELISA法检测血清vaspin水平,并分析其与UC临床特征的相关性。结果:UC患者血清vaspin水平显著高于正常对照者[(1.86±0.38)μg/L对(0.96±0.43)μg/L,P0.01],并与血清CRP水平和疾病活动指数呈显著正相关(r=0.628,P0.01;r=0.514,P0.05),与血清ESR水平和病变部位无关(r=0.098,P0.05;r=0.124,P0.0)5)。结论:Vaspin可能在UC发生、发展的病理生理机制中发挥重要作用。     

Serum Transglutaminase Correlates with Endoscopic and Histopathologic Grading in Patients with Ulcerative Colitis

Factor XIIIa, a circulating form of transglutaminase, plays a key role in intestinal mucosal repair. We found that transglutaminase levels are decreased in serum of patients with inflammatory bowel diseases and demonstrated in a rat model of chronic colitis that serum transglutaminase is closely related to the severity of intestinal damage. We aimed, therefore, to correlate serum transglutaminase levels with standard endoscopic and histopathologic grading systems in patients affected by ulcerative colitis (UC). In 249 patients with UC, we assayed serum transglutaminase activity by a radioenzymatic method and measured clinical activity index (CAI) according to modified Rachmilewitz's criteria. In a subset of 82 patients undergoing colonoscopy, endoscopic and histologic indices were studied. Biopsy specimens were also taken from 28 patients to measure myeloperoxidase (MPO) as a marker of mucosa inflammation. Serum transglutaminase levels significantly correlated with the CAI scoring (r = –0.63; P < 0.01); likewise serum transglutaminase showed the best correlation with endoscopic (r = –0.71; P < 0.001) and histologic (r = –0.79; P < 0.001) scores. Myeloperoxidase activity was significantly higher in patients with active UC than those in remission (P < 0.01), showing a significant correlation with serum transglutaminase levels (r = –0.68; P < 0.01). Immunohistochemistry showed factor XIIIa localization in the extracellular matrix of damaged mucosa. In conclusion, these results suggest that transglutaminase assay can be useful in managing UC as a serological, noninvasive indicator of intestinal mucosal status.     

C反应蛋白水平变化在急性呼吸窘迫综合征患者预后判断中的意义

目的 探讨C反应蛋白（CRP）指标变化在急性呼吸窘迫综合征（ARDS）患者预后判断中的意义.方法 收集我院呼吸内科重症监护室30例ARDS患者临床资料,根据患者临床预后分为死亡组及存活组,比较患者CRP变化在临床预后判断中的价值.结果 30例患者中,死亡20例,存活10例.死亡组与存活组患者的CRP基础值（确诊时）比较差异无显著性（P＞0.05）.存活组CRP治疗后较治疗前均降低,死亡组3例降低,17例升高.两组治疗后CRP比较差异显著（P＜0.01）.两组治疗前后CRP指标比较差异显著（P＜0.01）.治疗后CRP降低患者的病死率（23.1%,3/13）明显低于CRP升高患者的病死率（100%,17/17,P＜0.01）.结论 动态监测CRP水平的变化对判断ARDS患者的预后具有较为重要的指导意义.     

High serum C-reactive protein levels predict survival in patients with treated advanced lung adenocarcinoma

BackgroundThe prognosis of non-small cell lung cancer (NSCLC) varies greatly depending on whether or not it can receive molecular-targeted drug treatment including epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs). We investigated the clinical utility of C-reactive protein (CRP) levels measured at the time of diagnosis in EGFR-mutant and wild-type NSCLC patients who had undergone first-line therapy.MethodsSerum CRP levels were analyzed in 213 patients, of whom 89 patients had advanced EGFR-mutated NSCLC who underwent first-line EGFR-TKI treatment. We used Cox proportional hazards models to study the relationship between CRP and overall survival (OS). CRP cutoff values were obtained from the receiver operating characteristic curve.ResultsMean serum CRP level in treated NSCLC patients were not significantly different in patients with or without EGFR mutations. The optimal CRP cutoff values were 8.1 mg/L for EGFR-mutated NSCLC and 16.7 mg/L for EGFR-wild NSCLC. Based on multivariate analysis, high CRP level (EGFR-mutated, HR: 2.479, 95% CI: 1.331–4.619, P=0.004; EGFR-wild, HR: 3.625, 95% CI: 2.149–6.116, P<0.001) was a significant and independent negative prognostic factor for OS in patients with or without EGFR mutations.ConclusionsHigh CRP levels predicted a lack of response to treatment in patients with advanced lung adenocarcinoma with or without EGFR mutations. Thus, the CRP level is a good and easy to use prognostic factor and objective indicator for clinical practice.     

Increased circulating platelet-neutrophil, platelet-monocyte complexes, and platelet activation in patients with ulcerative colitis: a comparative study

It is reported that the incidence of thromboembolism is increased in ulcerative colitis (UC), and hypercoagulability persists even when patients are in remission. We evaluated the association of inflammatory response parameters with UC activity, and activation parameters of the platelets, endothelium, and the coagulation system in UC. Eighteen UC patients and 19 healthy subjects were included in the study. The patients' clinical features were recorded down; whole blood counts and acute phase parameters were evaluated. UC patients were divided into two as active (9 patients) and inactive (9 patients) according to combined clinical activity index (CAI) and endoscopic activity index (EAI) scores. In all subjects, platelet CD62P expression, platelet-monocyte complexes (PMC), platelet-neutrophil complexes (PNC), and platelet microparticles (PMP) were determined by flow cytometry. E-selectin, thrombin-antithrombin complex (TAT) levels in plasma, and sCD40L levels in serum were determined by ELISA. In both active and inactive UC patients, platelet CD62P expression, the percentages of PMC, and PNC were significantly higher than those in the control group (P< 0.01). PMP level was higher in the control group than in inactive UC patients (P = 0.001). sCD40L level was significantly higher in active UC group than in the control group (P < 0.01). EAI score correlated significantly with PMP (r = 0.5, P = 0.04) and sCD40L (r = 0.48, P = 0.044); CAI score had a negative correlation (r = -0.68, P = 0.002) with sE-selectin level. In addition to increased CD62P expression and sCD40L, increased formation of PMC and PNC suggests a role for platelet-leukocyte complex formation together with platelet activation in thromboembolic events observed in UC.     

Comparative usefulness of erythrocyte sedimentation rate and C-reactive protein in assessing the severity of ulcerative colitis]

BACKGROUND/AIMS: Although erythrocyte sedimentation rate (ESR) is included as a laboratory parameter in Truelove and Witts' classification, C-reactive protein (CRP) is also used for severity assessment in ulcerative colitis (UC). Frequently, the discordance between ESR and CRP is observed in clinical practice. The aim of this study was to determine which parameter is more related with clinical activity in UC patients. METHODS: A total of 155 patients with UC were identified from January 2004 to March 2005. Their medical records were reviewed within these patients, a total of 541 assessments of disease activity were made. Correlation of clinical activity and laboratory tests were evaluated by Pearson's correlation coefficient. RESULTS: Pearson's correlation coefficients of ESR and CRP with clinical symptoms were 0.376 and 0.258, respectively. The correlation coefficient between ESR and CRP was 0.403 (p=0.000). A total of 131 (24.2%) assessments revealed discordance between ESR and CRP. When discordance occurred, the correlation coefficients with clinical symptoms were 0.338 for ESR (p=0.000) and 0.034 for CRP (p>0.01). Dividing discordant patients into high ESR/low CRP group and low ESR/high CRP group, the coefficients were 0.420 for ESR and 0.226 for CRP in high ESR/low CRP group, and 0.333 for ESR and 0.068 for CRP in low ESR/high CRP group. CONCLUSIONS: The correlation analysis indicates that ESR appears to be a more reliable laboratory parameter of disease activity than CRP in assessing the severity of UC. In particular, when the level of ESR and CRP is discordant, ESR is more useful in assessing the disease activity in UC patients.     

5-脂氧合酶在溃疡性结肠炎黏膜中的表达

目的 检测溃疡性结肠炎（UC）患者结肠黏膜5-脂氧合酶（5-LOX）蛋白及5-LOXmRNA的表达及其与UC内镜分级、组织学分级的关系.方法 取32例UC患者结肠黏膜标本根据内镜及组织学进行分级,同时收集正常对照者结肠黏膜标本26例.采用实时荧光定量反转录聚合酶链反应和免疫组化法检测UC患者结肠黏膜5-LOX mRNA及蛋白的表达.结果 32例UC患者内镜分级Ⅰ级10例,Ⅱ级19例,Ⅲ级3例 组织学分级1级19例,2级9例,3级4例.UC患者结肠黏膜5-LOX mRNA和蛋白表达显著高于正常对照组（P＜0.05）,5-LOX蛋白的阳性表达率随内镜分级、组织学分级增加而增加 5-LOX蛋白表达与内镜分级之间存在相关（P＜0.05）,但与组织学分级之间不相关（P＞0.05）.结论 UC患者结肠黏膜中5-LOX mRNA和蛋白的表达增加,5-LOX蛋白的阳性表达率在一定程度上可以反映疾病的活动度,可作为UC治疗的靶位,在UC治疗中具有重要意义.     

抗血小板药物对脑梗死患者血小板-白细胞聚集体的影响

目的观察急性脑梗死患者血小板一白细胞聚集体（PLA）的变化以及阿司匹林和氯吡格雷对其的影响。方法对急性脑梗死和对照组患者血小板聚集率（PAR）、可溶性P选择素（sP—sel）、C-反应蛋白（CRP）和PLA进行检测。同时将急性脑梗死患者随机分为阿司匹林组和氯吡格雷组,观察两组患者治疗前后斯堪的纳维亚神经卒中量表（SNSS）评分、PAR、sP—sel、CRP和PLA的变化。结果急性脑梗死患者血小板单核细胞聚集体（PMA）显著高于对照组（P〈0．001）;PMA水平与PAR、sP-sel、CRP、血糖、胆固醇和纤维蛋白原正相关（P〈0．05）;与SNSS评分负相关（P〈0．05）。脑梗死患者治疗后PMA、PAR明显下降（P≤0．001）,且治疗后氯吡格雷组PMA和PAR（ADP）降低较阿司匹林组更明显（P〈0．05）,但PAR（AA）两组间差异无统计学意义;sP-sel在氯吡格雷组治疗后显著下降（P〈0．001）。结论急性脑梗死患者反映血小板活化的敏感指标PMA明显增高,阿司匹林和氯吡格雷可以降低PMA水平,其中氯吡格雷作用较阿司匹林更为明显。